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Colorado Antimicrobial Stewardship Endeavor (CASE)

CASE banner
cdphe, children's, and be antibiotics aware logos

About CASE: In August 2021, the Colorado Department of Public Health and Environment (CDPHE) partnered with Children’s Hospital Colorado to start the Colorado Antimicrobial Stewardship Endeavor (CASE). CASE includes physicians, pharmacists, and epidemiologists who provide mentorship and resources to Colorado hospitals that may be new to antibiotic stewardship. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing and use is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance. Learn more on the antimicrobial stewardship main page

Through a series of workshops and one-on-one consultations, CASE will support hospital antibiotic stewardship programs to:

  • Create evidence-based actions to improve antibiotic stewardship. 
  • Develop procedures to track and monitor antibiotic use and reporting.
  • Extend antibiotic stewardship activities to pediatric patients.
  • Develop programs that meet state and national standards and CDC’s Core Elements of Antibiotic Stewardship.
  • Interact with antimicrobial steward peers statewide.
  • Request one-on-one consultations from the CASE team.

CASE also seeks to provide resources such as treatment guidelines, support for reporting antibiotic use to the National Healthcare Safety Network (NHSN), and links to evidence-based guidelines and tools.

CASE workshop schedule 2024-2025

DatePresentation Slides
Workshop 1: Oct. 4, 2024, noon to 1pmRole of nurses in stewardship practices - Presentation | Recording

Registration does not expire! Join us any time before the last session. 
register for case link

Antimicrobial stewardship is one of the best tools we have to fight back against antimicrobial resistance. While there are multiple guidelines for common infectious processes, applying them at the local level can be a time-consuming challenge. Children’s Hospital Colorado and Denver Health have partnered with Firstline to create a mobile app to change that. 

advertisement for children's hospital antibiotic app

Firstline houses clinical pathways from Children’s and Denver health, along with antimicrobial dosing information, pathogen information, infection prevention information, and more. It is intended for use in all clinical settings. The app is free to download, and is available on iOS and Android devices, as well as a web-based format. CDPHE supports the Firstline app in an effort to provide antimicrobial stewardship treatment guidelines and resources across healthcare settings.

No matter your specialty or practice, we are all stewards. We can all work together in keeping Colorado healthy, one antibiotic choice at a time.

Use the QR code above to find our app. Once downloaded, you can set your location to Denver Health and/or Children’s Hospital Colorado to access all of our materials. Once in the app, clicking on the FirstLine logo in the top left corner will allow you to toggle between locations to access adult vs pediatric guidance. Contact cdphe_hai_ar@state.co.us for more information or feedback!

CASE is recruiting hospitals to participate in a nine-month quality improvement project to implement Firstline and measure and improve pathway adherence. In collaboration with Children's Hospital Colorado and Denver Health, CASE created a no-cost app through Firstline that contains antimicrobial stewardship-focused infectious diseases guidelines that can be used in all clinical settings.

Enrollment in the CARE PATH program will consist of: 

  • Using pathway adherence tools created by CASE to measure prescriber adherence to recommended antibiotic choice and duration for urinary tract infection, community acquired pneumonia, and/or skin and soft tissue infection. 
  • Entering adherence data into a secure REDCap database hosted by CDPHE 
  • Receiving an individualized feedback report with a summary of adherence data for use by your antibiotic stewardship team. Share your report with your prescribers and hospital leaders or keep it as documentation of your efforts for accreditation.

When: July 2024 through March 2025

Next steps: 

  • Include CARE PATH in your quality improvement plan.
  • Download the Firstline app through Apple or Android Store (see QR code above), and search for Children’s Hospital Colorado or Denver Health. 
  • Contact Joana Dimo, DO (joana.dimo@state.co.us) or cdphe_hai_ar@state.co.us for more information.
     

CARE PATH registration

recruitment poster pdf 

CARE PATH recruitment poster PDF

 

 

Kick-off workshop: June 14th, 2024, 
noon to 1pm

Introduction to CARE PATH Initiative: Colorado Antimicrobial Resources, Education and Pathway Adherence Tools for Hospitals - PresentationRecording

Fall Workshop: October 25, 2024 noon to 1pmTreatment of Urinary Tract Infections - Presentation I Recording

We have expanded CASE in partnership with the Office of Rural Health to offer an antimicrobial stewardship series focused on critical access and community hospitals!

We encourage ongoing participation in CASE for workshops, office hours, and consultations. The goal of the CASE collective is to promote outreach and facilitate discussion among antimicrobial stewards at smaller or resource-limited settings across the state.

We invite you to join four virtual interactive calls with peer facilities and the interdisciplinary CASE team from August to May. Participation is voluntary and at no-cost. Consultations and additional support are available through participation in CASE. Register for the CASE collective by contacting cdphe_hai_ar@state.co.us.
 

 

Speaker

Background

 

  

 

Speaker

Background

Spring 2024

Dr. Elizabeth Dodds-Ashley - PharmD, MHS, Professor of Medicine at Duke University, Director of DASON at Duke UniversityDr. Elizabeth Dodds-Ashley, is a Professor of Medicine and Director of Operations for the Duke Antimicrobial Stewardship Outreach Network (DASON) based at Duke University. During her 15 year career as an active antimicrobial stewardship pharmacist her work spans a variety of patient care settings including large academic medical centers, community hospitals and long term care facilities. She has served as a member of the Antimicrobial Resistance Working Group at the CDC, and an expert panel member of the Transatlantic Taskforce for Antimicrobial Resistance. She also served as the Society of Infectious Diseases Pharmacists (SIDP) representative on the Presidential Advisory Council on Antimicrobial Resistant Bacteria (PACCARB). She is actively involved in several professional societies engaged in stewardship including SHEA and SIDP.
Dr. Chris Evans - PharmD, Tennessee Department of Health HAI/AR pharmacist leadDr. Christopher Evans is a pharmacist with the Healthcare Associated Infections and Antimicrobial Resistance Program at the Tennessee Department of Health (DOH).  He received his Doctor of Pharmacy degree from the Campbell University School of Pharmacy and completed a pharmacy practice residency at Vidant Health.  He also completed an infectious diseases pharmacy residency at the University of Rochester Medical Center, where he later served as the Antimicrobial Stewardship Pharmacist.  His work at the Tennessee DOH focuses on improving antibiotic use in all areas of the healthcare continuum and investigation of cases of injectable drug diversion. His research interests include the clinical impact and metrics of antimicrobial stewardship programs and antibiotic use and resistance tracking. He maintains active memberships in SHEA and the Council for State and Territorial Epidemiologists.

Dr. Lauren Dutcher, MD, 

Assistant Professor of Medicine at University of Pennsylvania

Medical Director of Outpatient Parenteral Antibiotic Therapy Program and Associate Director of Antimicrobial Stewardship at the Hospital of the University of Pennsylvania

 

Dr. Lauren Dutcher obtained her medical degree from the University of Pennsylvania Perelman School of Medicine. She completed her Internal Medicine residency and adult Infectious Diseases fellowship at the University of Pennsylvania, as well as a Master of Science in Clinical Epidemiology during her fellowship. Dr. Dutcher conducts clinical and epidemiologic research in antibiotic stewardship, focused on better understanding and improving antibiotic prescribing in the inpatient and outpatient settings, particularly in primary care.

 

 

Dr. Rana El Feghaly, MD

Clinical Director for Infectious Diseases,

Director of Outpatient Antibiotic Stewardship Program and Quality Improvement at Children’s Mercy Kansas City Hospital, 

Professor of Pediatrics at University of Missouri-Kansas City School of Medicine

Dr El Feghaly received her medical degree from the Lebanese University in 2006. Following pediatrics residency at the State University of New York Upstate Medical University in Syracuse, NY, she completed her pediatric infectious diseases fellowship at Washington University School of Medicine. She joined Children’s Mercy Kansas City in 2017 where she’s been leading outpatient antibiotic stewardship efforts. She is currently leading SHARPS-OP, an international collaborative focused on improving antimicrobial stewardship in ambulatory settings. With her expertise in quality improvement, Dr El Feghaly’s research focuses on judicious use of antibiotics and diagnostic tests in the outpatient setting.

Fall 2023

Dr. Timothy Jenkins, MD

Infectious Disease Department Denver Health, 

Associate Professor of Medicine at University of Colorado School of Medicine. 

Dr. Jenkins has served as the Director of the Antimicrobial Stewardship Program at Denver Health for over 15 years and has been involved in antibiotic stewardship research, quality improvement, and policy development at the local, state, and national level. His research interests include the development of interventions to reduce antibiotic overuse in the hospital and ambulatory care settings, use of short-course antibiotic therapy to treat common infections, and the management of Staphylococcus aureus bloodstream infections. 

Dr. Nichole Poole, MD, MPH

Assistant Professor of Pediatrics,

Division of Infectious Diseases and Epidemiology at University of Colorado School of Medicine,

Associate Medical Director of ASP at Children’s Hospital Colorado

Dr. Poole obtained her medical degree at the University of Texas School of Medicine and a Master of Public Health at the University of Texas School of Public Health. She completed her pediatric residency at the University of Chicago School of Medicine  and her Pediatric Infectious Diseases fellowship at Seattle Children’s Hospital. Dr. Poole’s research area of interest is antimicrobial stewardship in ambulatory and community settings. Dr. Poole uses epidemiologic and quality improvement research methods to describe antibiotic prescribing patterns, identify targets for improvement, and study interventions to improve the quality of antibiotic use in children. Dr. Poole leads the CHCO Outpatient Antibiotic Stewardship Program that serves as a resource for providers who care for children across the State of Colorado.

Spring 2023

Alyssa Yang Castillo, MD

Assistant Professor of Medicine, Division of Infectious Diseases, University of Colorado School of Medicine

Dr. Alyssa Castillo is an Assistant Professor at the University of Colorado. She works clinically in general infectious diseases and serves as the Associate Medical Director for Infection Prevention & Control at the University of Colorado Hospital. She completed her clinical fellowship training at the University of Washington, where she worked closely with the UW Center for Stewardship in Medicine (CSiM, formerly TASP) to provide specialty didactic education and support to stewardship programs in rural and critical access hospitals in the Northwest region. Her primary academic area of interest is diagnostic stewardship which intersects antimicrobial stewardship and infection prevention -- impacting both antimicrobial use and healthcare associated infection (HAI) diagnosis and metric reporting.

Matthew Miller, PharmD, BCIDP

Infectious Diseases and Antimicrobial Stewardship Clinical Pharmacy Specialist, Children’s Hospital Colorado,

Assistant Clinical Professor, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, and University of Colorado School of Medicine

Matthew Miller is an experienced board-certified infectious diseases (ID) pharmacist who completed his PGY-2 at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. He served as the pharmacy lead for the antimicrobial stewardship (AS) program at the University of Colorado Hospital until his transition to Children’s Hospital Colorado in October 2022 as an AS and ID clinical pharmacist. He is passionate about integrating diagnostics with AS initiatives, as well as antimicrobial dose optimization through application of PK-PD principles in special populations.

 

Christine MacBrayne PharmD Antimicrobial Stewardship and Infectious Disease Clinical Pharmacist Specialist at Children’s Hospital Colorado

Christine MacBrayne graduated from the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences with her PharmD and went on to pursue a PGY-1 pharmacy practice residency at Children’s Hospital Colorado. Following residency, she completed a post-doctoral fellowship in antiviral pharmacokinetics at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. She has been in her current role since 2017 and has completed various quality improvement training certificate courses to help guide her antimicrobial stewardship efforts.

Stacy Volk PharmD

Stacy Volk is a clinical pharmacist specializing in antimicrobial stewardship and infectious diseases at Intermountain Health Lutheran Medical Center in Wheat Ridge, CO.  She is a graduate of the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and completed her PGY-1 pharmacy practice residency at the University of Louisville Hospital in Louisville, Kentucky.  She is a board certified infectious diseases pharmacist and is currently working to complete her Masters of Public Health degree from the University of Colorado School of Public Health.  Stacy has been in her current role since 2010 and has been working with NHSN AUR data since 2016 to help identify areas of opportunity to optimize antibiotic use at LMC

Leigh Anne Bakel, MD, MSc

Associate Professor of Pediatric Hospital Medicine, University of Colorado School of Medicine

Medical Director of Clinical Effectiveness and

Director of the Clinical Pathways Program, Children’s Hospital Colorado

 

Dr. Leigh Anne Bakel is a Pediatric Hospitalist at Children’s Hospital Colorado where she also serves as a Medical Director of Clinical Effectiveness, and the Director of the Clinical Pathways Program. Her masters in Clinical Epidemiology is backed by her extensive experience in research in clinical practice guidelines on an international level. She, with the help of the Clinical Effectiveness team, transformed the Clinical Pathways Program using process improvement strategies. Her areas of academic interest are building a national collaborative of pediatric Clinical Pathway Programs, improving implementation and dissemination of clinical pathways, and developing a Clinical Pathway Learning Health System to further improve outcomes for children.

 

Fall 2022

Alfredo J. Mena Lora, MD, FIDSA, FACP

Assistant Professor

University of Illinois Chicago, Saint Anthony Hospital

Chicago

Alfredo J. Mena Lora, MD FIDSA is an assistant professor at the University of Illinois at Chicago, where he serves as Program Director for the Infectious Diseases fellowship and Associate Program Director for the Internal Medicine residency. He directs Infection Prevention and Antimicrobial Stewardship at Saint Anthony Hospital. Dr. Mena Lora has an interest in antimicrobial use and resistance in the United States and abroad.

Jessica Zering, PharmD, BCPS

Antimicrobial Stewardship Pharmacist

Washington State Department of Health

Jessica Zering is a board-certified pharmacist with more than five years of experience working in antimicrobial stewardship at a critical access hospital. The stewardship program that she created at Astria Sunnyside Hospital is nationally recognized. It was featured on the CDC/HRSA webinar titled “Enhancing Antibiotic Stewardship Programs in Critical Access Hospitals” in November 2021 and in the February 2022 edition of the Medicare Beneficiary Quality Improvement Project (MBQIP) publication. She is passionate about protecting patients and communities from the unwanted consequences of antimicrobial use.

Fall 2021

Sarah Parker, MD CHCO

 

Sarah Parker, MD is an Infectious Diseases attending pediatric physician and the Medical Director for Children's Hospital Colorado Antimicrobial Stewardship Program.

Christine MacBrayne, PharmD CHCO

Christine MacBrayne, PharmD, MSCS, BCIDP is an Infectious Disease and Antimicrobial Stewardship Clinical Pharmacist Specialist at Children's Hospital Colorado.

Michael J. Bozzella, DO, MS CHCO

Michael Bozzella, DO is an Infectious Diseases attending pediatric physician and Antimicrobial Steward at Children’s Hospital Colorado. 

Matt Miller, PharmD CHCO (previously UCHealth)

Matt Miller, PharmD is an Infectious Disease and Antimicrobial Stewardship Clinical Pharmacist at Children's Hospital Colorado. 

Rana Hamdy, MD, MPH, MSCE Children’s National

Rana Hamdy, MD is an Infectious Disease Specialist and Investigator and the Director of the Antimicrobial Stewardship Program at Children's National Research Institute.

Marc Meyer, PharmD Southwest Health System

Marc Meyer, PharmD is the Director of Pharmacy Services and Infection Control and 340B Program at Southwest Health System.

Sarah Jung, PhD, D(ABMM)  Microbiology at CHCO

Sarah Jung, PhD is the Scientific Director of Clinical Microbiology at Children’s Hospital Colorado.

Jamey Atchison 

Microbiology at CHCO/Denver Health

Jamey Atchison is a Medical Technologist with Children’s Hospital Colorado. 

Kathleen Martinez, MSN, RN, CPN from IP/Epi at CHCO

Kathleen Martinez, BSN, MSN, RN, CPN is a Nurse in the Infection Prevention/Epidemiology Section at Children’s Hospital Colorado.

Heather Johnson, PharmD from CHCO

Heather Johnson, PharmD is an Antimicrobial Stewardship team-member at Children’s Hospital Colorado.

DatePresentation Slides
Workshop 1: Nov. 17, 2023, noon to 1pm“Short is in” Antibiotic Durations for Common Infections  -  Presentation | Recording
Workshop 2: Feb. 2, 2024, noon to 1pmExpanding your influence to improve antibiotic use in outpatient settings - 
Presentation I Recording
Workshop 3: April 5, 2024, noon to 1pmMaking the most of AUR - Presentation I Recording
Workshop 4: June 14, 2024, noon to 1pmIntroduction to CARE PATH Initiative: Colorado Antimicrobial Resources, Education, and Pathway Adherence Tools for Hospitals - Presentation I Recording
Spring 2023Presentation slides
Jan. 13, 2023Guideline development and adaptation -  Presentation | Recording
March 24, 2023ASP Data Management and NHSN AU Module Basics - Presentation | Recording
May 19, 2023Intersection of Diagnostic and Antimicrobial Stewardship - Presentation | Recording
Fall 2022Presentation slides
Nov. 18, 2022Stewardship in the community and critical access settings | Presentation video
Spring 2022Presentation slides
Jan. 21, 2022Stewardship Part 1: Why, who, how to keep track, and who to ask 
Feb. 25, 2022Stewardship Part 2: Pharmacy Power 
Apr. 22, 2022Stewardship Part 3: It starts with a handshake
June 24, 2022Stewardship Part 4: The Larger Team

CASE one-on-one consultations

People from our two teams work together to troubleshoot difficulties and help develop plans for improving your stewardship program over a 30-60 minute session. These sessions are tailored to your specific needs and situations. 

To schedule a session, email Michael J Bozzella DO MS (CASE Lead) at michael.bozzella@childrenscolorado.org or CDPHE at cdphe_hai_ar@state.co.us